レシピエントとは別世帯を営むきょうだいの，肝臓提供への意思決定プロセスとそれに影響する要因

The Decision-Making Process and the Factors Affecting That Process of Live Donors Who Have Their Own Family and Donate Their Liver to a Sibling

要旨

　目的：レシピエントとは別世帯を営むきょうだいの生体肝ドナーに焦点を当て，肝臓を提供しようと決意するまでの意思決定プロセスと，それに影響する要因を明らかにすることである．

　方法：ドナー5名に半構成的面接を実施し，質的帰納的に分析した．

　結果：提供の決意に至るプロセスには【きょうだいとの関係性】が影響し，【助けなければいけない】思いと，提供することでの【健康な自分が傷つけられる不安や恐怖】との葛藤が生じていた．【提供に納得がいくよう意味づけをする】ことは【助けなければいけない】という思いを強化し，【配偶者・家族の理解と支え】が【健康な自分が傷つけられる不安や恐怖】を支えていたことが示され，最終的には生体ドナーは【条件的に自分しかいないと決意】していた．

　結論：別世帯を営むきょうだいのドナーに対して慎重な意思決定支援と，配偶者や家族への関わりも含めた家族看護の必要性が示唆された．

Abstract

　Purpose: To clarify the decision-making process and factors that affect live donors who have their own family and donate their liver to a sibling.

　Methods: Semi-structured interviews were conducted with five subjects who were donors living with their own family and were a sibling of the recipient. The interviews were analyzed qualitatively and inductively.

　Results: In the decision-making process to donate, the "relationship with the sibling" is an influencing factor, and conflict occurs between two factors: "I must save my sibling's life" and "anxiety and fear that the procedure may damage my health." The "To find meaning of the donation as the donor" strengthens the belief that "I must save my sibling's life." In addition, the "understanding and support of the donor's spouse and family" reinforces the factor of "anxiety and fear that the procedure may damage my health." Ultimately, the donor "consents to donate because I choose to be a donor conditionally."

　Conclusions: The study findings suggest that the decision-making process requires careful support to be able to donate a liver to a sibling and that family and nursing support is necessary to care for the involved spouse and family.